1868 Prognostic Value of Preoperative Lymphocyte-Monocyte Ratio in Patients with Ovarian Clear Cell Carcinoma

Abstract

Study Objective The aim of the present study was to determine the prognostic significances of markers of preoperative systemic inflammatory response (SIR) in patients with ovarian clear cell carcinoma (OCCC). Design A total of 109 patients diagnosed with OCCC that underwent primary cytoreductive surgery and adjuvant platinum-based chemotherapy from 2009 to 2012 were enrolled in this retrospective study. SIR markers were calculated from complete blood cell counts determined before surgery. Setting This study was performed in Pusan National University Hospital, Busan, Korea Patients or Participants 109 OCCC patients that had underwent primary debulking and adjuvant paclitaxel and carboplatin chemotherapy at university hospitals between April 2007 and June 2012. Interventions Preoperative blood samples were drawn 1 to 2 weeks prior to surgery. ROC curve analysis was used to obtain optimal NLR, LMR and PLR cutoff values for predicting survival outcomes. Measurements and Main Results The optimized NLR, LMR and PLR cut-off values as determined by ROC curve analysis for PFS and OS were 2.3, 4.2, and 123.6, respectively. When the cohort was divided using these optimized cut-offs, NLR and LMR were found to be significantly associated with clinicopathologic factors, NLR with FIGO stage, the presence of malignant ascites, and platinum response, and LMR with FIGO stage, lymph node metastasis, malignant ascites, and platinum response. Kaplan-Meier analysis revealed a high NLR (> 2.3) was significantly associated with low 5-year PFS and OS rates and that a high LMR was significantly associated with high 5-year PFS and OS rates. Multivariate analysis identified FIGO stage, residual mass, and platinum response as independent prognostic factors of PFS, and FIGO stage, residual mass, platinum response, and LMR as independent prognostic factors of OS. Conclusion Markers of systemic inflammatory response provide useful prognostic information and lymphocyte-to-monocyte ratio is the most reliable independent prognostic factor of overall survival in patients with ovarian clear cell carcinoma.